银杏叶提取物对调节脑出血患者迟发性认知功能障碍的作用研究  

Effects of the improvement of neural function of Ginkgo biloba extract on delayed cognitive dysfunction after cerebral hemorrhage

作　　者：高灵利[1] 李晓晖[2] 李延红[1] 蒋令修[2] 王银萍 GAO Lingli;LI Xiaohui;LI Yanhong;JIANG Lingxiu;WANG Yinping(Department of General Medicine,First Affiliated Hospital of Henan University,Kaifeng,Henan 475000,China;Department of Neurology,First Affiliated Hospital of Henan University,Kaifeng,Henan 475000,China)

机构地区：[1]河南大学第一附属医院全科医学科,河南开封475000 [2]河南大学第一附属医院神经内科,河南开封475000

出　　处：《热带医学杂志》2025年第2期185-189,共5页Journal of Tropical Medicine

基　　金：河南省医学科技攻关计划项目(LH-GJ20210555);开封市科技发展计划项目(2404055)。

摘　　要：目的探究银杏叶提取物(GBE)对脑出血后迟发性认知功能障碍患者神经功能及热休克蛋白、β-淀粉样蛋白(Aβ)的影响并分析其作用机制。方法选取河南大学第一附属医院2020年11月-2023年12月收治的脑出血后迟发性认知功能障碍患者合计112例,使用随机数字表法将所有患者分为对照组及治疗组,各56例,对照组给予常规治疗,治疗组在其基础上加用GBE治疗。比较两组患者治疗前后神经功能及血清、脑脊液热休克蛋白、Aβ蛋白表达、5-羟色胺(5-HT)、去甲肾上腺素(NE)、多巴胺(DA)水平、乙酰胆碱酯酶(AChE)活性、单胺氧化酶B(MAO-B)活性。结果治疗前两组认知功能评分差异均无统计学意义(t=0.530、0.264,P均>0.05),治疗后治疗组简易智能精神状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)评分高于对照组,差异均有统计学意义(t=7.062、10.692,P均<0.05)。治疗后治疗组热激因子1(HSF-1)、热休克蛋白-70(HSP-70)、热休克蛋白-40(HSP-40)、热休克蛋白-27(HSP-27)相对表达高于对照组,差异均有统计学意义(t_(外周血)=20.844、23.956、20.624、23.004,t_(脑脊液)=33.466、25.373、44.468、29.702,P均<0.05)。治疗组泛素、血清淀粉样前体蛋白(APP)、磷酸化Tau蛋白(PHF-Tau)、Aβ相对表达水平低于对照组,差异均有统计学意义(t_(外周血)=21.417、16.604、33.466、36.130,t_(脑脊液)=42.391、21.037、28.446、31.793,P均<0.05)。治疗前两组5-HT、DA、NE水平差异均无统计学意义(t=0.097、0.064、0.060,P均>0.05),治疗后治疗组5-HT、DA、NE水平高于对照组,差异均有统计学意义(t=4.845、6.930、3.177,P均<0.05)。治疗组AChE、MAO-B活性低于对照组,差异均有统计学意义(t_(外周血)=18.508、20.957,t_(脑脊液)=15.910、19.738,P均<0.05)。结论GBE能提高脑出血后迟发性认知功能障碍患者热休克蛋白水平,抑制Aβ聚集和泛素沉积,降低AChE、MAO-B活性并提高神经递质水平,改善脑出�Objective To investigate the effects of Ginkgo biloba extract(GBE)on neurological function,heat shock protein and amyloid β-protein(Aβ)in patients with delayed cognitive dysfunction after cerebral hemorrhage and analyze its mechanism.Methods A total of 112 patients with delayed cognitive dysfunction after cerebral hemorrhage admitted to our hospital from November 2020 to December 2023 were selected as subjects of the study.Random number table method was used to divide some patients into control group and treatment group,with 56 cases in each group.The control group received conventional treatment,and the treatment group was treated with GBE on the basis of routine treatment.Neurological function,expression of heat shock protein,Aβ protein,levels of 5-hydroxytryptamine(5-HT),norepinephrine(NE),dopamine(DA),activity of acetylcholine esterase(AChE)and activity of monoamine oxidase B(MAO-B)in serum and cerebrospinal fluid were compared between the two groups before and after treatment.Results There was no significant difference in cognitive function scores between the two groups before treatment(t=0.530,0.264;both P>0.05).After treatment,mini-mental state examination(MMSE)and Montreal cognitive assessment(MoCA)scores in the treatment group were significantly higher than those in the control group(t=7.062,10.692;both P<0.05).The relative protein expressions of heat shock factor-1(HSF-1),heat shock protein-70(HSP-70),heat shock protein-40(HSP-40)and heat shock protein-27(HSP-27)in treatment group were significantly higher than those in control group(t_(peripheral blood)=20.844,23.956,20.624,23.004,t_(cerebrospinal fluid)=33.466,25.373,44.468,29.702;all P<0.05).The relative expressions of ubiquitin,amyloid protein precursor(APP),phosphorylated Tau protein(PHF-Tau)and Aβ in treatment group were significantly lower than those in control group(t_(peripheral blood)=21.417,16.604,33.466,36.130,t_(cerebrospinal fluid)=42.391,21.037,28.446,31.793;all P<0.05).There were no significant differences in the levels of 5-HT,DA an

关 键 词：银杏叶提取物 脑出血 迟发性认知功能障碍 热休克蛋白 Β-淀粉样蛋白 神经功能 

分 类 号：R743.34[医药卫生—神经病学与精神病学]